Journal of Postgraduate Medicine
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 CASE REPORT
Year : 2013  |  Volume : 59  |  Issue : 1  |  Page : 51-53

Pure red cell aplasia following autoimmune hemolytic anemia: An enigma


1 Department of Medicine, Medical College and Hospital, Kolkata, West Bengal, India
2 Department of Medicine, Institute of Hematology and Transfusion Medicine, Medical College, Kolkata, West Bengal, India

Correspondence Address:
S Ray
Department of Medicine, Medical College and Hospital, Kolkata, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0022-3859.109495

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A 26-year-old previously healthy female presented with a 6-month history of anemia. The laboratory findings revealed hemolytic anemia and direct antiglobulin test was positive. With a diagnosis of autoimmune hemolytic anemia (AIHA), prednisolone was started but was ineffective after 1 month of therapy. A bone marrow trephine biopsy revealed pure red cell aplasia (PRCA) showing severe erythroid hypoplasia. The case was considered PRCA following AIHA. This combination without clear underlying disease is rare. Human parvovirus B19 infection was not detected in the marrow aspirate during reticulocytopenia. The patient received azathioprine, and PRCA improved but significant hemolysis was once again documented with a high reticulocyte count. The short time interval between AIHA and PRCA phase suggested an increased possibility of the evolution of a single disease.






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Online since 12th February '04
2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow